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. 2022 Aug;31(8):2505-2518.
doi: 10.1007/s11136-022-03098-y. Epub 2022 Feb 17.

Living with cryptoglandular anal fistula: a qualitative investigation of the patient's experience through semi-structured patient interviews

Nusrat Iqbal  1   2 , Astrid J H M Machielsen  3 , Stephanie O Breukink  4   5   6 , Rebecca Woodcock  7 , Gillian Kane  8 , Laith Alrubaiy  9 , Ugo Grossi  10 , Merel L Kimman  11 , Phil J Tozer  12   13
Affiliations

Living with cryptoglandular anal fistula: a qualitative investigation of the patient's experience through semi-structured patient interviews

Nusrat Iqbal et al. Qual Life Res. 2022 Aug.

Abstract

Purpose: Cryptoglandular anal fistula continues to be a subject of extensive surgical research due to the lack of effective and enduring treatments, some of which incur risks to continence and quality of life. However, the patient experience of disease has seldom been reported. The aims of this study are to understand the impact of living with a fistula and the treatment outcomes that are valued by patients.

Methods: Patients with cryptoglandular anal fistula were recruited using purposive sampling from two tertiary referral centres in the UK and the Netherlands. Patients underwent semi-structured interviews that were audio-recorded and transcribed verbatim. Dutch transcripts were translated into English and underwent independent, thematic analysis using open coding by two study team members to identify common themes and sub-themes.

Results: Twenty interviews were conducted before saturation was reached (11 male, median age 49, Interquartile range 39-55 years). Four broad themes emerged, covering the physical symptoms of fistula, the patient journey towards understanding the condition, life impact, and treatment. Several inter-related sub-themes were found, reflecting the extensive impact and adjustment that the disease entails.

Conclusion: The impact of cryptoglandular anal fistula extends beyond the physical symptoms of pain and discharge, requires significant readjustment, and often negatively impacts psycho-social wellbeing. These aspects of disease should receive greater attention in future assessment of treatment and quality of life.

Keywords: Anal fistula; Qualitative research; Quality of life.

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Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Central themes and sub-themes deduced from patient interviews regarding experiences of living with cryptoglandular anal fistula
See this image and copyright information in PMC

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